Organization
SOUTHWESTERN OKLAHOMA STATE UNIVERSITY
Active
Other names
SWOSU Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (ADMINISTRATOR)
(972) 367-4845
Entity
Organization
Contact information
Practice address
100 CAMPUS DR, WEATHERFORD, OK 73096-3001
(972) 367-4845
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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